Organization and Personnel Section, Jinan Children's Hospital (Children's Hospital of Shandong University), Jinan 250022, China.
Enuresis Clinic of Tuina Department, Jinan Children's Hospital (Children's Hospital of Shandong University), Jinan 250022, China.
Medicine (Baltimore). 2022 Mar 11;101(10):e28875. doi: 10.1097/MD.0000000000028875.
X-linked chronic granulomatous disease (X-CGD) is an X-linked recessive disorder of the Nicotinamide adenine dinucleotide phosphate oxidase system that can cause primary immunodeficiency. Mutations in the CYBB gene located in Xp21.1 were accounting for X-CGD disease. More than 600 mutations have been identified as the cause of X-CGD in various populations worldwide.
In this study, the proband suffered from elevated white blood cells (WBC, 23.65 × 109/L), mainly in neutral (16.4 × 109/L). The neutrophil oxidative index of the patient was 2.13, which was extremely low, whereas his mother was 69.0 (Ref >100). Next, next-generation sequencing of the primary immunodeficiency diseases -related gene panel was performed. One novel mutation was identified in the CYBB gene in the CGD case: c.55C>G in exon 2. The mutation was verified by Sanger sequencing. The mother of the patient was heterozygous for the c.55C>G mutation, and the father was normal. These mutations were not present in the 100 unrelated normal controls.
The patient died from severe and uncontrollable pulmonary infection at 3 months of age.
The identification of these mutations in this study further expands the spectrum of known CYBB gene mutations and contributes to the genetic counseling and prenatal molecular diagnosis of X-CGD.
X 连锁慢性肉芽肿病(X-CGD)是一种 NADPH 氧化酶系统的 X 连锁隐性遗传病,可导致原发性免疫缺陷。位于 Xp21.1 的 CYBB 基因突变是 X-CGD 的病因。在世界范围内的不同人群中,已经发现了超过 600 种突变可导致 X-CGD。
本研究中的先证者白细胞(WBC)升高(23.65×109/L),主要为中性粒细胞(16.4×109/L)。患者的中性粒细胞氧化指数为 2.13,极低,而其母亲为 69.0(参考值>100)。随后,对原发性免疫缺陷病相关基因panel 进行了下一代测序。在 CGD 病例中发现了 CYBB 基因中的一个新突变:c.55C>G 位于外显子 2。该突变通过 Sanger 测序得到验证。患者的母亲为 c.55C>G 突变的杂合子,而父亲正常。这些突变在 100 名无关的正常对照中均未出现。
患者在 3 个月大时因严重且无法控制的肺部感染而死亡。
本研究中这些突变的鉴定进一步扩展了已知 CYBB 基因突变谱,有助于 X-CGD 的遗传咨询和产前分子诊断。